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The dietary acid load created by the typical Western diet may adversely impact the skeleton by disrupting calcium metabolism. Whether neutralizing dietary acid with alkaline potassium salts results in sustained improvements in calcium balance remains controversial. In this randomized, double-blind, placebo-controlled study, 52 men and women (mean age 65.2 ± 6.2 years) were randomly assigned to potassium citrate 60 mmol/d, 90 mmol/d, or placebo daily with measurements of bone turnover markers, net acid excretion, and calcium metabolism, including intestinal fractional calcium absorption and calcium balance, obtained at baseline and at 6 months. At 6 months, net acid excretion was significantly lower in both treatment groups compared to placebo and it was negative, meaning subjects' dietary acid was completely neutralized (-11.3 mmol/d on 60 mmol/d; -29.5 mmol/d on 90 mmol/d, p < 0.001 compared to placebo). At 6 months, 24-hour urine calcium was significantly reduced in persons taking potassium citrate 60 mmol/d (-46 ± 15.9 mg/d) and 90 mmol/d (-59 ± 31.6 mg/d) compared with placebo (p < 0.01). Fractional calcium absorption was not changed by potassium citrate supplementation. Net calcium balance was significantly improved in participants taking potassium citrate 90 mmol/d compared to placebo (142 ± 80 mg/d on 90 mmol/d versus -80 ± 54 mg/d on placebo; p = 0.02). Calcium balance was also improved on potassium citrate 60 mmol/d, but this did not reach statistical significance (p = 0.18). Serum C-telopeptide decreased significantly in both potassium citrate groups compared to placebo (-34.6 ± 39.1 ng/L on 90 mmol/d, p = 0.05; -71.6 ± 40.7 ng/L on 60 mmol/d, p = 0.02) whereas bone-specific alkaline phosphatase did not change. Intact parathyroid hormone was significantly decreased in the 90 mmol/d group (p = 0.01). Readily available, safe, and easily administered in an oral form, potassium citrate has the potential to improve skeletal health. Longer-term trials with definitive outcomes such as bone density and fracture are needed.

Osteoblast function was investigated in 27 patients with idiopathic osteoporosis. Transiliac bone biopsy specimens were taken after double labelling with tetracycline, and metabolic calcium balance was studied almost simultaneously. Many of the patients showed poor double labelling of their otherwise unremarkable trabecular osteoid, suggesting impaired formation of bone at many of these surfaces. This phenomenon was not accompanied by increased width of osteoid seams (as seen in osteomalacia), indicating that formation of the matrix and its mineralisation were in equilibrium. For the first time, highly significant positive correlations (p less than 0.01) were found between indices of bone formation, determined by labelling with tetracycline, and calcium balance. Thus some patients with osteoporosis who are rapidly losing bone have low rates of formation of trabecular bone both by individual osteoblasts and in relation to available bone surfaces. As histological indices of bone resorption also independently correlated strongly and inversely (p less than 0.01) with calcium balance the rate of initiation of new basic multicellular units by osteoclastic resorption of trabecular surfaces (or the depth of resorption at these surfaces) also appears to be an important determinant of mineral balance. The mechanisms that regulate the effective life span of mature osteoblasts require further investigation, particularly as some promising treatments that can increase trabecular bone volume in osteoporosis, such as parathyroid peptide hPTH (1-34) and sodium fluoride, must work through a reversal of osteoblastic depression.

P(論文), http://www.tsc-05.ac.jp/pdf_library/2014.pdf

This chapter discusses the role of calcium balance in aging. Calcium balance is the resultant of several interacting forces, including nutrition, hormonal status, disuse, and general involution. Minimization of the structural impact of a negative calcium balance (that is, a depleted skeleton) requires a multifaceted approach, including, but not limited to, an adequate calcium intake. Because calcium utilization is inefficient even during growth; and becomes more so with age; calcium intake requirements are high, and rise with age. Intakes of calcium for healthy elderly persons should be in the range of 1400–1600 mg/day, and patients with osteoporosis being treated with bone active agents may need substantially more to realize the full benefit of their antiosteoporosis therapies. The goal of a high calcium intake in the elderly is both to make certain that inadequate calcium is not compounding the other negative factors influencing the aging skeleton. and to support any bone-building potential that may reside in current and future antiosteoporosis therapies.

Calcium balance in chronic kidney disease is poorly understood as calcium deficiency is a stimulus for secondary hyperparathyroidism and consequent bone loss while calcium excess promotes extraosseous calcifications. To help resolve this, we evaluated calcium balance in normal individuals and in patients with chronic kidney disease (CKD) on daily diets containing 800 and 2000 mg elemental calcium. Both normal individuals and patients with late stage 3 and stage 4 CKD were in slightly negative to neutral calcium balance on the 800-mg calcium diet. Normal individuals were in modest positive calcium balance on the 2000-mg diet, while patients with CKD on the same diet were in marked positive calcium balance at least over the 9 days of study; and significantly greater than the normal individuals. Increased calcium intake significantly decreased 1,25-dihydroxy-vitamin D and intact parathyroid hormone levels but did not alter the serum calcium concentration. Thus, our findings have important implications for both preventing calcium deficiency and loading in individuals with late stage 3 and stage 4 CKD.

The acid-ash hypothesis posits that protein and grain foods, with a low potassium intake, produce a diet acid load, net acid excretion (NAE), increased urine calcium, and release of calcium from the skeleton, leading to osteoporosis. The objectives of this meta-analysis were to assess the effect of changes in NAE, by manipulation of healthy adult subjects' acid-base intakes, on urine calcium, calcium balance, and a marker of bone metabolism, N-telopeptides. This meta-analysis was limited to studies that used superior methodological quality for the study of calcium metabolism. We systematically searched the literature and included studies if subjects were randomized to the interventions and followed the recommendations of the Institute of Medicine's Panel on Calcium and Related Nutrients for calcium studies. Five of 16 studies met the inclusion criteria. The studies altered the amount and/or type of protein. Despite a significant linear relationship between an increase in NAE and urinary calcium (p < 0.0001), there was no relationship between a change of NAE and a change of calcium balance (p = 0.38; power = 94%). There was no relationship between a change of NAE and a change in the marker of bone metabolism, N-telopeptides (p = 0.95). In conclusion, this meta-analysis does not support the concept that the calciuria associated with higher NAE reflects a net loss of whole body calcium. There is no evidence from superior quality balance studies that increasing the diet acid load promotes skeletal bone mineral loss or osteoporosis. Changes of urine calcium do not accurately represent calcium balance. Promotion of the "alkaline diet" to prevent calcium loss is not justified.

The debate on the most adequate dialysate calcium concentration for intermittent haemodialysis therapy is ongoing. There is probably no one optimal concentration. In general, one would like to maintain a neutral calcium balance in adult haemodialysis patients. However, a slightly negative balance may be preferable to avoid soft-tissue calcium accumulation in face of net calcium loss from the bone with ageing. The problem with measurements of calcium balance is that they are generally imprecise, as are estimations of total body calcium and its distribution in various compartments, unless done with labour-intensive methods and great care. The choice of the dialysate calcium will depend on several factors, including parathyroid and vitamin D status, type and severity of concomitant bone disease, presence or absence of arterial calcification, dietary habits, drug treatment and dialysis modality. Ideally the dialysate calcium would be adapted to each patient's needs. This is not feasible, however, in most dialysis settings and neither is it cost-effective. From a practical point of view, a relatively high dialysate calcium concentration in the range of of 1.50-1.75 mmol/L (3.0-3.5 mEq/L) should probably be preferred in haemodialysis patients with high serum PTH levels who are not prescribed calcium-based phosphate binders or high doses of active vitamin D sterols, and in those who are receiving a calcimimetic. In those who are treated with high doses of calcium-based binders and/or active vitamin D derivatives or who have a very low serum PTH level, the optimal dialysate calcium concentration is probably lower, in the range of 1.25-1.50 mmol/L (2.50-3.0 mEq/L). In the present pro/con debate about the optimal dialysate calcium concentration used for the haemodialysis session, we have accepted to defend the viewpoint that a low calcium concentration may do more harm than benefit in many patients. This viewpoint is opposite to that taken by Gotch [1]. He argues that since calcitriol and other active vitamin D derivatives have become available virtually all haemodialysis patients are in positive calcium balance. We would like to take issue with this statement and warn against the indiscriminate use of a low calcium dialysate in all patients receiving haemodialysis therapy.

45Ca kinetics and calcium balance studies allow for the simultaneous determination of calcium movement in the intestines, kidneys and bones. Since the flow of minerals in each of these organs depends on those in other organs, it is important to evaluate calcium movement as a whole throughout the entire body. Morphological methods can be used to evaluate local bone formation and resorption microscopically within defined windows. However, bone remodeling does not proceed equally in every part of the skeleton, and local events tend to be misread as general phenomena. Although variables such as bone formation and resorption obtained in 45Ca kinetics and calcium balance studies tell nothing about the location of these events, and the concept of compartments can be somewhat difficult to understand, this method is still useful for obtaining quite reliable results compared to those obtained by other methods. Our review describes the concept of the compartment model and explains the pertinent methods in comparison with other methods.

Objective: Fructus ligustri lucidi (FLL) is a widely used herb in China that is classically included in antiaging formulas for the treatment of age-related symptoms. Our laboratory previously showed that FLL could regulate calcium balance in young ovariectomized (OVX) rats. In the present study, we aimed to determine whether FLL could regulate calcium balance in aged OVX rats and to study the potential mechanisms that mediate its action in vivo. Design: Aged OVX rats were orally administered an ethanol extract of FLL and its vehicle and fed with diets containing different levels of calcium [low calcium diet (LCD), 0.1% Ca; medium calcium diet (MCD), 0.6% Ca; and high calcium diet (HCD), 1.2% Ca] for 12 weeks. Results: Significant reductions in urinary and fecal calcium excretion were found in the FLL-treated animals, resulting in a significant induction of calcium retention in rats fed with the MCD and HCD. FLL treatment significantly increased the serum 1,25-dihydroxyvitamin D 3 level and slightly decreased the serum parathyroid hormone level in OVX rats fed with the MCD and HCD. When OVX rats were challenged by LCD, the inductions of serum parathyroid hormone and 1,25-dihydroxyvitamin D 3 were decreased by FLL administration. FLL treatment significantly up-regulated duodenal vitamin D receptor and calcium transport protein 1 mRNA expression in rats fed with the HCD. FLL treatment reduced the expression of renal vitamin D receptor and 25-hydroxyvitamin D-24-hydroxylase mRNA in OVX rats fed with the LCD and MCD. Conclusions: Twelve weeks of FLL treatment could reduce calcium loss, modulate the parathyroid hormone-vitamin D axis, and increase vitamin D-dependent calcium transport in aged OVX rats, suggesting that FLL might be useful as an alternative medicine for improving calcium balance in postmenopausal women.

Few calcium balance data are available from young children on which to base dietary recommendations.The objective of the study was to evaluate the relation between calcium intake and balance in healthy children aged 1-4 y consuming typical American diets.Subjects were assigned to a diet with nutrient intakes similar to those of their usual diet. Calcium absorption was assessed by using a dual-tracer stable-isotope technique. Endogenous fecal excretion was measured in a subset of children, and net calcium balance was calculated.Mean calcium intake was 551 mg/d (range: 124-983 mg/d), and mean (+/-SEM) calcium retention was 161 +/- 17 mg/d. Both linear and nonlinear modeling of balance data showed that a calcium intake of approximately 470 mg/d led to calcium retention of 140 mg/d, which is the amount that meets expected bone growth needs in children of this age. No evidence was found that calcium intakes of 800 to 900 mg/d reached the threshold intake beyond which no additional increase in calcium retention would occur.Bone growth needs in 1-4-y-old children following American diets are met by a daily calcium intake of approximately 470 mg/d, which suggests that the current Adequate Intake of 500 mg/d is close to the actual Estimated Average Requirement. The benefits and risks of higher calcium intakes consistent with threshold values should be evaluated in a controlled trial before those intakes could be used as a basis for dietary recommendations.

Calcium balance and its major components (true calcium absorption, urinary calcium excretion and intestinal calcium secretion) were assessed by a 6-d balance technique in young (6-wk-old) rats fed a diet containing 7.2 g Ca/kg diet. Following either oophorectomy (oophx) or sham operation, the balance study was repeated at 9, 12 and 15 wk of age. Calcium balance decreased with age but remained positive in each group [mean (pooled SEM): sham, (6 wk) 0.86 to (15 wk) 0.27 (0.03) mmol/d (P < 0.0001); oophx, (6 wk) 0.91 to (15 wk) 0.22 (0.03) mmol/d (P < 0.0001)]. Analysis of variance of the change in calcium balance indicated that there was a significantly greater reduction in calcium balance in the oophx group compared with the sham-operated group. Intestinal calcium absorption decreased in each group with age [sham: (6 wk) 46.3% to (15 wk) 22.6% (1.5%) (P < 0.0001); oophx: (6 wk) 48.2% to (15 wk) 21.2% (1.5%) (P < 0.0001)]. There was a marked rise in intestinal calcium secretion in the oophx group compared with the sham-operated group at 6 wk post-operation (12 wk of age) [oophx: 0.33 (0.02) mmol/d; sham: 0.23 (0.02) mmol/d (P < 0.01)]. Urinary calcium excretion was not affected by either age or oophorectomy. We conclude that oophorectomy in young rats leads to a reduction in calcium accumulation, which is mainly the result of an increase in intestinal calcium secretion.

The use of high ultrafiltration rates in haemodiafiltration (HDF) has been suggested for improving the clearance of small and large molecules. This strategy has become economically applicable with the development of safe techniques for on-line production of sterile infusate from dialysate, which enables us to infuse large substitution fluid volumes without further increasing the cost of sessions. The effect of increasing the ultrafiltration rate in HDF on electrolyte balance has not yet been evaluated. The aim of this study was to evaluate the effects of variations of the ultrafiltration rate on calcium kinetics in HDF using three different dialysate calcium concentrations. Since the increase in ultrafiltration rate augments the convective calcium loss, variations of intrasession calcium balance could result from modifications of the ultrafiltration rate. In the present study we found no significant variations in calcium balance and serum ionized calcium (iCa) levels during on-line HDF treatment when increasing the mean ultrafiltration rate from 60 to 100 ml/min in the presence of an adequate and corresponding increase in the infusion rate (from 2.5 to 5 l/h). During the balance studies, pretreatment serum iCa was on the average 1.32 mmol/l and weight loss 3.2 kg. Mean calcium loss during treatment was 2.8 and 3.3 mmol at infusion rates of 2.5 and 5 l/h with 1.63 mmol/l of calcium in both the dialysate and infusate; calcium loss rose to 5.9 and 11.2 mmol at infusion rates of 2.5 l/h and to 5.7 and 14.2 mmol at infusion rates of 5 l/h when the dialysate and infusate calcium was reduced respectively to 1.5 and 1.25 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)

Chinese dietary reference intakes for calcium are largely based on foreign studies. We undertook meta-regression to estimate calcium requirements for Chinese adults derived from calcium balance data in Chinese adults.We searched PubMed, Cochrane CENTRAL, and SinoMed from inception to March 5, 2014, by using a structured search strategy. The bibliographies of any relevant papers and journals were also screened for potentially eligible studies. We extracted a standardized data set from studies in Chinese adults that reported calcium balance data. The relationship between calcium intake and output was examined by an individual participant data (IPD) and aggregate data (AD) meta-regression.We identified 11 metabolic studies in Chinese adults within 18-60 years of age. One hundred and forty-one IPD (n = 35) expressed as mg/d, 127 IPD (n = 32) expressed as mg×kg body wt(-1)×d(-1), and 44 AD (n = 132) expressed as mg/d were collected. The models predicted a neutral calcium balance (defined as calcium output (Y) equal to calcium intake (C)) at intakes of 460 mg/d (Y = 0.60C+183.98) and 8.27 mg×kg body wt(-1)×d(-1) (Y = 0.60C+3.33) for IPD, or 409 mg/d (Y = 0.66C+139.00) for AD. Calcium requirements at upper intakes were higher than that at lower intakes in all these models.Calcium requirement for Chinese adults 18-60 years of age approximately ranges between 400 mg/d and 500 mg/d when consuming traditional plant-based Chinese diets.

Controversy persists over: 1) how best to restore low serum 25-hydroxyvitamin D (25D) levels (vitamin D2 [D2] vs vitamin D3 [D3]); 2) how best to define vitamin D status (total [protein-bound + free] vs free 25D); and 3) how best to assess the bioactivity of free 25D.To assess: 1) the effects of D2 vs D3 on serum total and free 25D; and 2) whether change in intact PTH (iPTH) is more strongly associated with change in total vs free 25D.Participants previously enrolled in a D2 vs D3 trial were matched for age, body mass index, and race/ethnicity. Participants received 50 000 IU of D2 or D3 twice weekly for 5 weeks, followed by a 5-week equilibration period. Biochemical assessment was performed at baseline and at 10 weeks.Thirty-eight adults (19 D2 and 19 D3) ≥18 years of age with baseline 25D levels30 ng/mL were recruited from an academic ambulatory osteoporosis clinic.Serum measures were total 25D, free 25D (directly measured), 1,25-dihydroxyvitamin D, calcium, and iPTH. Urine measure was fasting calcium:creatinine ratio.Baseline total (22.2 ± 3.3 vs 23.3 ± 7.2 ng/mL; P = .5) and free (5.4 ± 0.8 vs 5.3 ± 1.7 pg/mL; P = .8) 25D levels were similar between D2 and D3 groups. Increases in total (+27.6 vs +12.2 ng/mL; P = .001) and free (+3.6 vs +6.2 pg/mL; P = .02) 25D levels were greater with D3 vs D2. Percentage change in iPTH was significantly associated with change in free (but not total) 25D, without and with adjustment for supplementation regimen, change in 1,25-dihydroxyvitamin D, and change in calcium.D3 increased total and free 25D levels to a greater extent than D2. Free 25D may be superior to total 25D as a marker of vitamin D bioactivity.

We examined the effect of vitamin K and vitamin D supplementation on calcium balance in young rats fed a normal or low calcium diet. Eighty female Sprague-Dawley rats, 6 wk of age, were randomized by the stratified weight method into eight groups with 10 rats in each group: 0.5% (normal) or 0.1% (low) calcium diet, 0.5% or 0.1% calcium diet+vitamin K (vitamin K2, menatetrenone, 30 mg/100 g, food intake), 0.5% or 0.1% calcium diet+vitamin D (25 microg/100 g, food intake), and 0.5% or 0.1% calcium diet+vitamin K+vitamin D. The duration of the study was 10 wk. Vitamin K supplementation promoted the reduction in urinary calcium excretion and retarded the abnormal elevation of serum PTH level in rats fed a low calcium diet, and stimulated intestinal calcium absorption in rats fed a normal calcium diet. Vitamin D supplementation stimulated intestinal calcium absorption with prevention of the abnormal elevation of serum PTH levels and prevented hypocalcemia in rats fed a low calcium diet, and stimulated intestinal calcium absorption in rats fed a normal calcium diet. The stimulation of intestinal calcium absorption was associated with increased serum 1,25-dihydroxyvitamin D levels. An additive effect of vitamin K and vitamin D on intestinal calcium absorption was found only in rats fed a normal calcium diet. This study shows the differential effects of vitamin K and vitamin D supplementation on calcium balance in young rats fed a normal or low calcium diet.

This study was conducted to evaluate the effect of Sigma Anti-bonding Molecule Calcium Carbonate (SAC) as therapy for ovariectomy-induced osteoporosis in rats. Three weeks after surgery, fifteen ovariectomized Sprague-Dawley rats were divided randomly into 3 groups: sham-operated group (sham), ovariectomized group (OVX) and SAC-treatment group (OVX+SAC). The OVX+SAC group was given drinking water containing 0.0012% SAC for 12 weeks. Bone breaking force and mineralization as well as blood parameters related to the bone metabolism were analyzed. In OVX animals, blood concentration of 17β-estradiol decreased significantly, while osteocalcin and type I collagen C-terminal telopeptides (CTx) increased. Breaking force, bone mineral density (BMD), calcium and phosphorus in femurs, as well as uterine and vaginal weights, decreased significantly following OVX. However, SAC treatment (0.0012% in drinking water) not only remarkably restored the decreased 17β-estradiol and increased osteocalcin and CTx concentrations, but also recovered decreased femoral breaking force, BMD, calcium and phosphorus, although it did not reversed reproductive organ weights. It is suggested that SAC effectively improve bone density by preventing bone turnover mediated osteocalcin, CTx and minerals, and that it could be a potential candidate for therapy or prevention of postmenopausal osteoporosis.

Fructus Ligustri Lucidi(FLL) is a commonly prescribed herb in many kidney-tonifying Traditional Chinese Medicinal formulae for the treatment of osteoporosis. The present study aimed to identify the active fractions in FLL and to characterise its effects on Ca balance, calciotropic hormone levels as well as bone properties in mature female rats fed diets containing different levels of Ca. In the present study, 4-month-old Sprague–Dawley female rats were treated with either FLL ethanol extract (EE), ethyl acetate-soluble fraction of EE (EAF), water-soluble fraction of EE (WF) or their vehicle for 12 weeks on a medium-Ca diet (MCD, 0·6 % Ca, 0·65 % P). Then, the Sprague–Dawley female rats treated with WF or its vehicle for 12 weeks were fed diets containing different levels of dietary Ca (low-Ca diet (LCD), 0·1 % Ca, 0·65 % P; MCD; high-Ca diet (HCD), 1·2 % Ca, 0·65 % P). The results demonstrated that WF from EE but not EAF exerted a prominent effect on Ca balance by inhibiting urinary and faecal Ca excretion. WF significantly increased Ca balance in rats fed MCD or HCD with an associated increase in serum parathyroid hormone (PTH) levels. WF did not alter bone mineral density or bone mineral content of the tibia in all the rats fed with different levels of dietary Ca. In conclusion, WF was responsible for the positive actions of FLL on Ca absorption and balance. The regulation of Ca balance by WF might involve its action in stimulating PTH production in the mature female rats.

Chronic renal failure (CRF) is a progressive, irreversible deterioration of kidney function that leads to complete loss of kidney function and the need for dialysis treatment. Bone disease is a chronic complication in the CRF and poses a significant problem in hemodialysis patients. The aim of our study was to assess the influence of peritoneal dialysis treatment on biochemical parameters of mineral and bone metabolism in hemodialysis patients, and identify the most important parameters for the monitoring of this disorder. The research involved 172 patients, mean age 58.69±12:54, divided into groups in respect to the length of dialysis treatment (group I - 5 years, group II - 5-10 years and group III - over 10 years). Serum phosphorus in all the patients was increased, but the values increased with duration of dialysis (I: 1.77±0.58, II: 1.97±0.66, III: 1.92±0.82), with no statistical differences (p>0.05). Calcemia values were significantly increased (I vs. II. and I vs. III, p

The amount of phosphorus contained in food as food additives is currently increasing and a high intake of phosphorus can cause various diseases. To determine the effects of a prolonged high phosphorus diet, here we investigated the phosphorus and calcium balance and expression of type IIa sodium-dependent phosphate transporter (Npt IIa) in mature rats. Wistar male rats (8-weeks old) were divided into five groups and fed diets containing 0.6% calcium plus 0.3, 0.6, 0.9, 1.2 or 1.5% phosphorus for 4 weeks. Urinary and fecal phosphorus excretions were significantly increased by the high phosphorus diets (from 0.6 to 1.5%), dependent on the amount of dietary phosphorus. The net absorption of intestinal phosphorus was also significantly increased by high phosphorus diets. As a result, a negative phosphorus balance was observed in rats given the 1.2% or 1.5% phosphorus diets. Serum parathyroid hormone and 1,25-dihydroxyvitamin D(3) concentrations were increased by high phosphorus diets. In addition, high phosphorus diets decreased the expression of Npt IIa mRNA and protein in the renal brush border membrane. Taken together, these results suggest that diets containing 1.2 or 1.5% phosphorus plus 0.6% calcium have potentially adverse effects on phosphorus homeostasis in mature rat.

Objective Bone mineral density is compromised in individuals with cystic fibrosis (CF); calcium is the major bone mineral. This study examined the impact of endogenous fecal calcium (V endo ) losses on calcium balance in girls with CF. Study design V endo was measured in 12 girls with CF (aged 7-18 years): 7 younger, premenarcheal girls with compromised nutritional status; and 5 older, postmenarcheal girls with adequate nutritional status. V endo was measured as the amount of intravenously administered 42 Ca, a calcium stable isotope, in stool relative to urine over 6 days. V endo was compared between pre- and postmenarcheal girls by Student's t test. Actual calcium balance [absorbed calcium−(urinary calcium (V u )+V endo )] was compared with estimated balance (assuming V endo =1.6 mg/kg/day calcium) by paired t test. Results V endo was 99.3±42.3 mg/day. By body weight, V endo was highest among premenarcheal girls (3.37±1.09 mg/kg/day), resulting in excess losses (>1.6 mg/kg/day) of 55.0±45.7 mg/day. Over 1 year, this represents 20.1±16.7 g of unattained bone calcium or 6.7±4.2% of the bone calcium content of these girls. Conclusions V endo is a significant source of calcium loss in individuals with CF and may limit calcium availability for bone mineral deposition.

Chinese dietary reference intakes (DRIs) for calcium were developed mainly from studies conducted amongst Caucasians, yet a recent review showed that reference calcium intakes for Asians are likely to be different from those of Caucasians (Lee and Jiang, 2008). In order to develop calcium DRIs for Chinese adolescents, it is necessary to explore the characteristics and potential influencing factors of calcium metabolic balance in Chinese adolescents. A total of 80 students (15.1+/-0.8 years) were recruited stratified by gender from a 1-year calcium supplementation study. Subjects were randomly designed to four groups and supplemented with calcium carbonate tablets providing elemental calcium at 63, 354, 660, and 966 mg/day, respectively. Subjects consumed food from a 3-day cycle menu prepared by staff for 10 days. Elemental calcium in samples of foods, feces, and urine was determined in duplicates by inductively coupled plasma atomic emission spectrometry. The total calcium intake ranged from 352 to 1323 mg/day. The calcium apparent absorption efficiency and retention in boys were significantly higher than that in girls (68.7% vs. 46.4%, 480 mg/day vs. 204 mg/day, P

Summary 1. The influences of dietary phosphorus (P) and food concentration on the calcium (Ca) balance in Daphnia magna were examined in this study at two different ambient Ca concentrations (0.5 and 10 mg Ca L−1). Daphnia were grown by feeding the young adults differentially under contrasting dietary P conditions [molar C : P ratio = c. 900 and c. 90 as low P (LP) and high P (HP), respectively], ambient Ca concentrations [0.5 mg and 10 mg Ca L−1 as low Ca (LCa) or high Ca (HCa), respectively] and food levels [0.15 or 1.5 mg C L−1 as low food (LF) or high food (HF), respectively] for 5 days. 2. The specific Ca contents of daphniids (1.9–6.5% of dry weight−1) increased with increasing Ca concentration, food level and dietary P content, although the food level did not affect the Ca content in the HPHCa treatment. A radioactive tracer method showed that the food level did not affect the influx of Ca from the water under LP conditions, but the Ca influx under HP conditions doubled with a HF level. A LP condition also led to a decrease in Ca influx with a HF level. 3. During the 3 days of efflux, generally only a small proportion of Ca (2.6–3.3%) was retained by the daphniids, but this retention increased (14–23%) under low ambient Ca concentrations and under P-limitation. Excretion was the most important pathway for Ca loss (accounting for 50–60% of body Ca), followed by moulting (20–47%), but the relative contribution of these two pathways (excretion and moulting) did not vary among all the different treatments. The absolute loss of Ca through excretion and moulting, on the contrary, differed with different ambient Ca concentrations and dietary P conditions. A HF level led to an increase in the loss rates in most cases. 4. Our study strongly suggested that there is an interaction between an essential metal (Ca) and macronutrients (C and P) in freshwater crustaceans with HCa and P contents. The results imply that variation in environmental nutrient conditions may change the Ca budget in crustaceans and may affect the dynamics of Ca in the epilimnion of freshwaters.

Summary Twelve adult female patients and 16 children who had undergone augmentation cystoplasty at least 2 years previously were studied to assess calcium balance and skeletal mineralisation. The serum and 24-h urinary calcium levels were measured and arterial blood gas analysis was performed in all patients. In children, skeletal mineralisation was assessed by serial study of their growth charts, comparing their growth centiles before and after cystoplasty. In adults, skeletal mineralisation was assessed by dual photon absorptiometry (DPA). As previously reported, all patients had a metabolic acidosis, usually with respiratory compensation. Serum and 24-h urinary calcium levels were all within the normal range. Growth charts of the 6 children with colocystoplasties showed an average of 20% reduction in growth potential in 3 of them. Growth charts in the 10 children with ileocystoplasties did not show any change in growth pattern. DPA bone scans in adults were all normal. These results suggest that if calcium is mobilised from bone in patients with a cystoplasty as a result of the metabolic acidosis, then it is reabsorbed from the bladder by the gut segment after an ileocystoplasty; colonic segments are less efficient than ileal segments, however, so that after a colocystoplasty skeletal demineralisation or a reduction in growth potential is more likely.